耐甲氧西林葡萄球菌检测方法的比较  

Evaluation of techniques for detection of Methicillin resistant Staphylococcus

作　　者：阴晴[1] 李阳[1] 段秀杰[1] 陆建成[1] 高雁[1] 

机构地区：[1]江苏大学附属医院检验科,江苏镇江212001

出　　处：《中国现代医学杂志》2007年第9期1115-1117,共3页China Journal of Modern Medicine

摘　　要：目的以PCR法检测葡萄球菌的mecA基因为金标准,比较头孢西丁纸片扩散法、苯唑西林纸片扩散法和乳胶凝集法检测耐甲氧西林葡萄球菌(MRS)的优缺点。方法对临床分离的70株葡萄球菌(其中金黄色葡萄球菌40株,凝固酶阴性的葡萄球菌30株)分别用PCR法、头孢西丁纸片扩散法、苯唑西林纸片扩散法和乳胶凝集法检测耐甲氧西林葡萄球菌,药敏试验方法按标准KB(Kirby Bauer)法进行。结果经PCR法检测mecA基因,耐甲氧西林的金葡菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的发生率分别为75.0%(30/40)和80.0%(24/30);头孢西丁纸片扩散法检测MRSA和MRCNS的敏感性、特异性分别为93.3%、95.9%;90.0%和100%;苯唑西林纸片扩散法检测MRSA和MRCNS的敏感性、特异性分别为90.0%、87.5%;90.0%和83.3%;乳胶凝集法检测MRSA和MRCNS的敏感性、特异性分别为100.0%、100.0%;100.0%和100.0%。与PCR结果比较,3种方法所获得的结果经统计学分析,差异无显著性。结论头孢西丁纸片扩散法、苯唑西林纸片扩散法是成批检测的理想方法;乳胶凝集法检测快速,结果可靠,但检测成本高;实验室应选择合适的方法,以提高MRS的检出率。[Objective] To evaluate the effectiveness of the Cefoxitin disk diffusion method, Oxacillin disk diffusion method and Screen latex agglutination for detecting MRS using PCR amplification of mecA gene as reference. [Methods] PCR amplification of the mecA gene, disk diffusion method with Cefoxitin and OxaciUin testing by Kirby-Bauer method, Screen latex agglutination test were performed to analyze 70 clinical isolates of Staphylococcus. [Results] 75.0% （30/40） were MRSA, 80.0% （24/30） were MRCNS confirmed by PCR of mecA gene. The sensitivity and specifity of Cefoxitin disk diffusion for detection of MRSA and MRCNS were 93.3%, 95.9% and 90.0%, 100% respectively. The sensitivity and specifity of OxaciUin disk diffusion for detection of MRSA and MRCNS were 90.0%, 87.5% and 90.0%, 83.3% respectively. The sensitivity and specifity of screen latex agglutination for detection of MRSA and MRCNS were 100.0%, 100.0% and 100.0%, 100.0% respectively. Comparing with PCR, there were no remarkable differences with these methods. [Conclusion] Cefoxitin disk diffusion method, Oxacillin disk diffusion method and screen latex agglutination method are applicable in clinical microbiology laboratory. Cefoxitin and Oxacillin disk diffusion methods are the ideal methods for testing wholesale, screen latex agglutination method is faster and the result is credibile, but it costs more. For the purpose of raising MRS detection rate, the laboratory should choose suitable method to test.

关 键 词：耐甲氧西林葡萄球菌 头孢西丁纸片扩散法 苯唑西林纸片扩散法 乳胶凝集法 聚合链反应 MECA基因 

分 类 号：R378.11[医药卫生—病原生物学]